“Kinda miserable”

As I was meeting with my dietitian on Monday, she ended up asking me how I think this really is going. I knew she didn’t want my BS “okay” or “pretty good” answer. There is no fooling her. (The woman reads my Recovery Record logs where I write what I’m actually feeling/eating, so she definitely can see through it all.)

I thought for a minute and ultimately landed on “kinda miserable.” I only realized after thinking about it for a couple days that this too is a pretty downplayed answer.

When I think of miserable, I start to imagine some situation so bad you would do anything to get out of it. Miserable is how I felt when I had swine flu, lost my grandpa, went through a hard breakup, and had my Nuss procedure. Those times in my life held lots of physical or emotional discomfort, to the point where even thinking about it brings a shudder. I would never choose to repeat those situations and many others I consider bad enough to call miserable.

So why then, did I use “kinda miserable” to describe how I’m feeling now?

I guess the miserable part fits to an extent. I did just provide K with a list of signs and symptoms of starvation I’m experiencing, and those are not exactly fun (unless being cold with bruises all over and thinning hair is your idea of a good time). It is definitely bothersome dealing with ED thoughts all day long. Sometimes I just wish that I could eat like “normal” people and not be so bothered.

At the same time, the eating disorder is 1000% providing me good things, too. If that wasn’t the case I probably could have recovered years ago. I think that’s where the “kinda” part comes through. I’m not sure if its more me being in denial or what, but I cannot say that I am fully miserable in the ED. I’m just not.

My answer here may not be the full truth, because I am not at a point where I’m willing to completely denounce the ED. Maybe I need more time. I can imagine my team asking “what will be enough, then?” to which I have no clue. Right now, it is enough to admit that sometimes, in some ways following the eating disorder has brought me discomfort.


I wanted to start with a catch up post, given that I have missed nearly 6 months of my life in this absence from blogging. I do plan on an update or two, but for now this was on my mind and I needed to write about that. I’ll be back with more soon!

We do not use “this is a good/bad food” here.

I’ll admit it, I was super pessimistic and anxious going into today. I was 110% certain I would be writing a post that pretty much said the opposite of this, but here we are instead.

I’ll have more on my experience in clinical this semester soon, but I’ll explain a little context for now. We are back, for the next 6 weeks, in the same community I was at for half of fall semester last year. It’s truly been incredible so far. One of the many projects we’re working on involves a teaching program for nutrition. It was developed to be used at different faith-based settings like one in our neighborhood. All I knew heading into today was that we were going to help teach these people about healthier eating and spending patterns. I think I probably took in a big gulp of air at that point and didn’t release that tension until the last three minutes of training today.

I was so very stressed about the program because I have seen how diet culture leeches into any and every single health-based program I can think of. I remember watching as (unknowingly) a classmate ended up teaching on something that sounded like it came from a dieting 101 class. I’ve seen materials for children more focused on saying what you should and shouldn’t eat or how bad fat is rather than promoting a picture of trying to choose more nutritious foods. I could go on, but essentially I just assumed I would be semi-forced to follow a curriculum that I cannot fully support.

I waiting for any of many disappointing phrases all session, until this one made me smile: “we do not use language like ‘this is a good/bad food’ here.” I could have hugged her, I swear. She went on to explain that the goal is to encourage nutritious choices, such as whole grains, but to avoid language that insinuates it is bad if you eat xyz. They don’t believe that causing people to feel guilty about their food choices is a good tactic (ESPECIALLY in our mostly low-income/homeless population). I could not agree more, and I am excited to reach these people in a way that can teach nutrition without it sounding like a guide for weight loss.

I often struggle deeply with believing that I am bad for what I do or do not eat. The ED thoughts scream if I even think about enjoying something that’s off limits. While this is not a “practice what I preach” scenario yet, I am grateful that I can promote a healthy relationship with food to some of the most vulnerable in our community. Maybe along the way I can re-learn a little, too!

Three potatoes.

*Quick note: this post will go more into ED thoughts and behaviors than I typically have. Please do not read on if that sort of talk would trigger you.*

I have been eating with my therapist every single Monday this entire semester (and twice a week for the last month). The point of these meals is for me to challenge myself in an environment where I’ll have support and, hopefully, be able to handle it better. That definitely has not been the case every week. I’m slightly ashamed to admit that the meals have including pleading, justifying, a few flat-out refusals, lots of bargaining, and supplementation when I just couldn’t handle the challenge.

I look back and wonder why I would spend so much time fighting my therapist rather than just doing what I’m supposed to, but it really isn’t so simple. The eating disorder is manipulative and it will find any opportunity to take over, even if it’s a seemingly minuscule way. That brings us to yesterday.

Like every other Monday, I had my dietitian check my meal before our session ended, then spent the next 30 minutes trying to focus on anything but the food I had to eat. This meal was still a challenge to me, not in content so much as amount. I felt semi-okay about it at first. I managed to eat a pretty good portion before something in my brain flipped. Suddenly I needed to stop, throw the rest away, and run out of therapy. While that didn’t happen, I did do something I’m not the most proud of: when R wasn’t looking (or who knows, maybe she could have been?), I quickly covered up the three pieces of potatoes I had left and continued on to a less scary portion of my meal. I still had more to complete after that, but it was like a calm came over my thoughts for a little while. I had gotten away with restriction right in front of my therapist, a huge win for ED.

It wasn’t those three tiny potatoes. It had zero to do with the negligible difference they would make in my life had I consumed them. It was solely about control. I am certainly not able to flat-out refuse meals when I’m in treatment, but this felt almost the same high as if I had. Another recent example was choosing not to try a new yogurt that sounded good because it was a whopping 10 calories more than my “safe” choice. Is that honestly going to do a damn thing?

While the glaring, logical answer may be “heck no!”, I’m not convinced. Part of me still believes these lies that the ED shouts at me each day. Life seems easier/”better” when I follow ED rules.

Some behaviors such as these ones trend towards being a bit ridiculous. They in no way will end with me magically staying thinner or losing weight or whatever other promise ED makes up. I can often notice my eating disorder manipulate other people, but truly isn’t it just doing the same to me?

I’m not sure if I want to change things, even knowing that I am the one being manipulated, too. For now I will keep fighting, and try to eat those potatoes next time.

Birthday post pt 1: 22

Last week, I turned 23. I truly can say that 22 was the fastest year of my life thus far. The days were long and full of struggle, but I sit here today (one whole week into my 23rd year) wondering how the hell it passed on by so quickly.

I’ve been in a reflecty/nostalgic sort of mood lately, so I wanted to look back on all this year brought.

The good:

  • Made it through the first year of nursing school! And did better than I ever thought!! This one deserves all the exclamation points. If I had to name one thing that made 22 pass by so dang fast, this would be it. I started out still very uncertain in my ability to truly be a nurse. I knew I could probably handle it academically and I love learning anyways, but working with patients was the real unknown. I’m grateful for the progress I’ve been able to make. I feel a thousand times more comfortable with patients now. I can see the ways I’ve grown and I’m proud of that.
  • Kept on going, no matter what. I’ve faced many obstacles this year. There were infinite moments I could have given up or given in. I did at times, of course, but overall I chose to fight instead. My stubbornness and resiliency helped me stay afloat in a pretty wide range of areas.
  • FINALLY got on good medications. I have zero shame about being on psychiatric meds. I felt pretty ambivalent about them before, but I finally ended up changing some things around with a new psychiatrist and the difference is CRAZY! I am so so glad I listened and decided to make steps towards healthy.
  • Giving up perfectionism in tiny ways. My nursing classes have naturally brought greater challenge and less likelihood of just acing a test without studying. This means I’m not the straight A student I once was. I’m learning to be okay with it, though. Test scores this year have had a large range, but I now can at least fight the negative thoughts that come with a B. It doesn’t have to ruin my day or week anymore.

The bad:

  • Lost my Challenge Queen title. My nickname at residential was always the “Challenge Queen” because I went above and beyond to fight back against the ED. This meant daily fear foods and completing difficult assignments, opening up more, etc. Ever since then I’ve tried to implement that same mentality. It has been seriously lacking this year. I have done pretty much the bare minimum (or less) and that’s it. I have no desire to try harder and make progress. This is frustrating and I feel stuck, but I also don’t want to make a change.
  • Relapse and treatment. Well I couldn’t exactly talk about the bad parts of this year if I skipped this whole part. I spent nearly all of 22 in varying stages of relapse. It was miserable and probably a large part of why the days were so very long as weeks and months whizzed by. This relapse was bad enough that I ended up in PHP for a month, something I swore I would NEVER do again. I still carry around a great deal of shame for everything that happened ED wise when I *should* have been better by now.
  • Isolation. This past year has brought way too many days with little to no human interaction minus what was absolutely necessary (think going to class and the dining hall). I sat in my room more often than not. If I did happen to do something socially, it was always support group or bible study or hanging out with treatment buddies. Most of the time i just felt too broken for anyone else.
  • Less time enjoying. I didn’t allow myself to sit back and relax with a book or go out on a photo shoot. My days were filled with monotony and not much to look forward to. I also got very stuck in the “work, work, work” mindset.
  • Giving up my passions. I’m pretty sure that my photo count for the year is in the hundreds (instead of thousands). I’ve also written way less than I had hoped/wanted to. Somewhere along the way, I just stopped caring about doing things I love.

22 wasn’t a bad year by any means. It certainly didn’t turn out as I’d hoped, but I have faith knowing that even the hard points are shaping me. I’ve learned and grown through it all, and that matters. I’m (mostly) ready to take on 23 and make it better than the last.

Part 2 is coming soon where I’ll explore my goals for the next year

Whirlwind

Holy cow, it has been crazy. I mean to update last Tuesday, and then Wednesday, Thursday, and so on until we get to tonight. I’ve been busy and exhausted, because I started PHP a week ago. I remember the beginning of this year. One of my top goals/intentions was to avoid treatment at all costs. Ironically, this quest to avoid has actually harmed my recovery. I have been so, so adamant against treatment that it took me a month (and the IOP team forcing it) for my to agree. I know hindsight is 20/20 and all that, but I actually wish I had listened, dangit.

I guess I may as well start off where I left off. Rather than make a separate post, I’m going to insert what I wrote and didn’t publish last Tuesday.


 

July 31st is a significant day in my life. It is my person’s day of birth (love you Livvy!) and also when I first went into eating disorder treatment.

4 years ago today, I was pushed into this huge world of what eating disorder treatment looked like. It was terrifying, confusing, frustrating, with some understanding mixed in.

If you had asked me 4 years ago where I would be now, I’m not sure that recovered would be the answer. Later on it definitely became the ideal future, but at that moment I was just so stuck into the ED. Treatment wasn’t optional and I was angry that I had to change.

Today I was back at the same hospital I started at 4 years ago. I’m not in clinicals anymore and there wasn’t support group. I had an intake assessment and tomorrow I will head back for my first day of PHP.

I cried the entire way there. It’s really hard to see that I’m in this spot again. I do feel a little hopeless and discouraged. How could I not, given how much I’ve wanted to stay strong/avoid treatment?

My disordered thoughts are very present right now, and one of the most pressing is “I am just in the same place as 4 years ago and that makes me a failure.” Yes, I am struggling enough to go to PHP. I am not in the same place, though. I can never go backwards in that way. I’ve grown, a TON. No amount of relapse can change that fact.


 

The past 6 days of PHP haven’t really gone quite as expected. I had plenty of expectations going in: irrational (I’m going to weigh 50 pounds more than everyone, I’ll have to eat a full meal plan right away, they’ll put me inpatient) and more realistic (it will be hard, I’ll have the same annoying nutrition groups, the adult PHP is terrible/dramatic). I also had an incredible amount of worries that didn’t stop at one full sheet of paper. I realized that probably wasn’t helping any and attempted to distract instead. Some things I didn’t count on happening:

  • Having a treatment center reunion since there are 3 of us from IOP there currently
  • A huge group, between 10-13! I know this is tiny compared to some treatment programs, but we barely fit in the one room and need to eat lunch in the huge room.
  • Being semi-terrified walking through certain units. The first day I recognized 5ish staff members from when I was in clinicals. For some reason, that freaked me right out and I’ve been ducking my head each time we go in the unit where I spent the most time.
  • The whole adult PHP room full. We actually didn’t have enough chairs today, so my friend and I sat on the floor. It’s pretty intimidating/annoying to have that many people staring at us as we come in and leave approximately 75 times every day. Luckily, we’re only there for 2-2.5 hours per day, which is more than enough.
  • Eating every 2 hours (sometimes less!!!). So I completely forgot about this part, or maybe blocked it out. We have breakfast at 8, morning snack at 10, lunch at noon, and snack at 2. Typically lunch and breakfast will both run late and that means even less time between meals. I knew volume would be hard, but I think eating this close together is harder even. I just get full by morning snack, then have to down even more. I haven’t been eating dinner until at least 6 because I’m still full/uncomfortable. I wish I could have started on an even smaller meal plan to try to reduce this, but I know that wasn’t going to happen. I really hope I/my body eventually gets used to it.
  • Not knowing a discharge date (or even a vague idea). My main psychiatrist did leave for vacation Friday, which was just day 3, so it is understandable. What bothers me is that there is no time frame whatsoever. My case manager yesterday said she had set up appts with my dietitian, therapist, and psychiatrist when she can’t tell me when I could be done. I’ve learned now that I have to avoid thinking about it for now, and just hear from my psychiatrist next Monday.
  • My defiant side coming out. Okay maybe I shouldn’t be all that surprised, but the ED is not taking any of this treatment BS. I have had urges to throw out food when no one was looking, nearly cried when the AT remembered to give us snack, secretly rejoiced as I saw my breakfast tray was lacking one exchange. I don’t do all I need for dinner. I’m not always doing “the work” part either. I don’t know, I guess I just thought it would magically be fine if I just took the leap to PHP. In reality, I am feeling quite a lot like 2014 PHP Emily.
  • The other patients are not too triggering!!!!!! That deserves all the excitement since it was one of my many excuses not to do partial. I was prepared for the worse and just haven’t seen it. Yes, there are others way thinner than I am, but I’ve found that I don’t necessarily want to be more like them. Behaviors are used unbeknownst to the staff, but I’ve kinda come to the conclusion that I cannot base my recovery off that. We are supportive of each other. Some don’t finish meals/finish Ensures and that doesn’t bother me too much either. Overall, it’s a pretty fun environment. We have some hilarious conversations and plenty of inappropriate ones too (also, all the swear words aha). That is so very needed in a setting like this.
  • I get to work with a psych resident one on one!! I saved the best for last. She and I have a 10-15 minute meeting each morning. I don’t get to see my case manager pretty much ever, so this has been a great time to process and really be open about progress and struggles. She’s been challenging me everyday and actually holds me accountable for those goals. I just feel very grateful I am one of the patients who get to work with her because I totally expected to maybe have 2 individual meetings a week.

PHP isn’t as bad as I expected it to be. I spend plenty of time wanting to run away and never come back. I think that’s pretty normal, though. I have come back each day to do the hard things anyways.

After all of the fighting and whining and complaining and driving my treatment team bonkers (I’m sure), I can semi/kinda/mostly admit it: I needed a higher level of care. I haven’t eaten this amount of food in a day for at minimum 6 months. That alone was never going to happen with IOP. 5x a week 8-3 means my world is invaded by treatment, but I can see this as a good thing. It means spending more time on recovery. I can’t ignore that need forever. So, while I can think of a million and one other activities I would enjoy more than PHP, I am here. I am going to be in a healthier place for school. Quoting one of my favorite dietitians: “I can guarantee you’ll find more happiness without the eating disorder, BUT THERE’S WORK.”


To finish this off, a few treatment goals that go beyond the very generic “improve healthy eating” or “learn coping skills” that we check off on our sheets.

  • Be able to tolerate the meal plan when I’m not in treatment
  • Get into the recovery mindset where I can put that first.
  • Push through the hard days because eventually they do get better.
  • Journal and make goals each day.
  • Do the little things, too – gratitude, worksheets, assignments, etc.
  • Come to a point where I am working for my recovery and not kicking and screaming every step of the way
  • Feel confident going into this next year
  • Don’t limit my exercise to compensatory only

Those are some pretty lofty, open-ended goals, but for a reason (of course I do have all the SMART goals on a small scale, though). Recovery is not black and white. I’m trying to be flexible here because I know how much feeling like a failure can harm me. I aiming for growth and not just perfection

Sorry for how long this has become, oops. It feels nice to have this all out here now. I hope to document this journey as I go. Processing it here is always helpful and something to look back on later.

Defiant with a capital D

Sometimes, the eating disorder takes over and makes me act like a five year old. Yesterday was one of those times.

I am still on weight gain protocol. I hate it with every ounce of my being. This means that if I lose or maintain when I’m under this certain weight range, I will need to supplement. It’s frustrating for a number of reasons. Ed strongly objects because I can’t possibly be expected to gain weight. Boost/Ensure is simply gross. I feel like I’m being punished in comparison to drinking a supplement because I did something to deserve it (like skip a meal or refuse to finish something at treatment). There’s also the whole pride piece, especially when I have to do it around other clients.

Every day of IOP starts with a weigh-in. Yesterday, L the dietitian weighed me. We go way back and she knows all of my tricks/beliefs/arguments really well. It’s hard to “get away” with anything while she’s there. This leads to us butting heads quite often and definitely contributed to what went down.

After she weighed me, L couldn’t find my chart and subsequently wasn’t able to check my weight from Monday. Her suggestion was for me to have a supplement anyways based on how close it was to last week’s weight (which she somehow remembered a week later?). I immediately refused. I was NOT about to voluntarily drink a Boost when I didn’t for sure need it. So, I didn’t. I told her if she expects me to drink one she had to know before.

I thought I had been really sly about the situation and there was no chance that I would need to supplement. When L summoned me out of art I knew I was wrong. She contacted R/K and found out that I had lost weight since Monday. I immediately got super annoyed and tried to fight it. I was/still am convinced that this was a fluke. I had a lot of bloat going on Monday, so naturally I would have lost a little weight jut from that. Apparently, that doesn’t count as a good enough reason to bypass the supplement.

Once I realized that there was no getting out of it, I became mad at the world/IOP/L/whoever had the terrible idea to make Boost. I drank the damn thing, but did so slowly with lots of disgusted facial expressions and the slightest bit of arguing back. I shut down and didn’t ask for what I need because of it. I feel like I didn’t benefit much from the last 2ish hours of IOP, other than getting in a snack.

I’m now over a day removed and in a more reflective headspace. In those moments I felt so angry and completely ignored the whole recovery thing. Ed gets irrational and emotional to the point where it can halt progress or cause harm. I hate supplements and everything, but maybe it would have been better to just agree to one before L found out for sure. I’m not following my dietary goals, so the Boost is making up for what I’m lacking nutritiously. Of course the ED can’t accept that as truth, but at east I’m able to consider it.

I hate who I become when I’m stuck in the ED thoughts and behaviors. My entire focus is avoiding food, exercise, weight loss, etc. I’m not a fun person to be around and I get like a little kid who has tantrums again. Someday maybe the recovery side will take over and I’ll no longer be so apt to the regression. For now, I just want to recognize when the ED takes over these moments so I can find some way to stop it. I won’t be the defiant one forever.

“The day”

The funny thing is, I asked for this. I presented a more in depth take on my treatment history, specifically the summer of 2015, to my team some weeks ago. I skated by that entire summer. Did I need a higher level of care week 1, maybe not. But then NTS camp came and went. My level of struggle at that point, early-mid July, was enough for treatment. I fought hard. Legally, my therapist could do nothing except coax me into telling my parents since she didn’t have a release to talk to them. I used this position to run my own treatment until I hit a major crisis point. By mid-August, I no longer had the luxury of over a month to cushion between then and moving in to college. I had maybe 12 days by the time I told my parents that I was struggling hard and needed inpatient. I spent a week at the hospital then went to orientation a couple days later. That wasn’t truly enough since I ended up in residential a few months later. I’ll never know for sure; however, there’s a chance that it could have been prevented if I had gotten help when I was knee deep in the hole instead of consumed by Ed.

I know how bad that summer was. Ending my last week with a psych hospital stay really stunk, but everything that came before was miserable too. I looked like a normal person, acted like I was perfectly wonderfully fine, but really felt dead on the inside. I honestly can’t remember much of that time other than NTS camp (mainly from pictures). Someone was asking me at work how different things were the first summer v now and I couldn’t think of a whole ton. That makes sense considering I was passing out while cleaning showers and not at all fueling my body. The only other memories are from inpatient. I never would expect every day to be some amazing adventure, but I longed for a summer to look back on fondly.

Another huge goal from the very beginning was to get back on track and into a healthy place for fall. I always struggle at the start of semesters or other areas of big change, so I need some higher ground to fall back on. I took the recovery focused step to tell my team that I wanted an end date, a time where we would seriously evaluate my progress and see what should happen. Monday July 9 worked great, since it was after we returned from Ludington and about halfway through the summer. I basically promised to consider whatever recommendation they might have. Part of me now really regrets asking this of them at all.

For probably a month now my team has had parameters where, if met, I would have to be honest about my struggle. I never hit that but it had no effect on the number of times this was brought up. There has been a lot more serious talk lately, so many “if, then’s” and possible outcomes. I’m not sure why I still expected different today.

We didn’t take the hour therapy appointment to talk through my vacation and other ups/downs of the past two weeks. It was briefly touched on and then R started on the part I didn’t want to hear: she and K both think I would benefit from a couple weeks in partial. It isn’t a set in stone, this is happening for sure thing yet. I’ll have a week still to figure this all out. The first step would be talking to my parents about how I’m struggling. Ideally, I apparently should have done this weeks ago at least. The second step is PHP (partial hospitalization program – around 7 hrs a day). I offered an alternative of C. none of the above. I have a million and one reasons (excuses?) about why neither work. They don’t buy it at all. I saw that coming, of course.

I have a week to figure this out, or as I say get my shit together. There are a couple options here: accept their plan(s) and my inability to handle this, come up with an alternative that will actually be approved, or make some major progress. I felt about .03% hopeful until K squashed that with my goals for the week. They seem really lofty and not something quite possible. I’m not sure if she thinks I can do it or wants to show that I do need help. Regardless, I know this is going to require a lot more effort than I’ve been giving.

I don’t have a clue where things will stand in 7 days. I could be heading into a fun picnic lunch (super excited about this actually) and then a less painful dietitian appointment with therapy the next day. On the other hand, it could be devastating and hard and result in a call with the place I swore I would never be back to.

Yes, I can technically refuse any and all recommendations, but I don’t know that I have a ton of power in what happens from here. Even my best effort may not be enough of a push. I could be kicked out of outpatient.

I want nothing more than to keep outpatient, working 4-5 days a week, enjoying some freedom, and taking time to relax. This may be the best possible time to go through treatment and big change. Maybe, maybe, I might benefit from telling my parents or doing PHP. But it could blow up in my face and be terrible. I guess I won’t really know until something happens.

For now, I will be scared and stressed and unsure. It’s all I’ve been thinking of for nearly 14 hours. I need some sleep, and maybe motivation in the morning. I’ll have a nice full day of work to check out a bit and then star figuring this out later. I can’t promise myself that I can fight, but I can make sure to at least consider all of my choices and not just the one I like.